腹腔镜下肌瘤剔除术与开腹手术对患者卵巢功能和免疫功能的影响

Effect of Laparoscopic Myomectomy and Transabdominal Myomectomy on Ovarian Function and Immune Function in Patients with Uterine Fibroid

目的观察腹腔镜下肌瘤剔除术与开腹手术对患者卵巢功能和免疫功能的影响。方法选择2017年7月-2018年6月治疗的子宫肌瘤患者80例,应用随机数表法分为两组,均40例。对照组行开腹手术治疗,观察组行腹腔镜下子宫肌瘤剔除术治疗。观察两组手术前后卵巢功能[促卵泡生成激素(FSH)、促黄体生成激素(LH)]、免疫功能指标[CD4+、CD8+、CD4+/CD8+]。结果术前两组FSH、LH、CD4+、CD8+、CD4+/CD8+水平对比,差异无统计学意义(P>0.05);术后观察组FSH(20.40±1.48)U/L、LH(19.15±1.24)U/L、CD8+(29.10±2.63)%水平低于对照组(23.97±1.54)U/L、(22.57±1.38)U/L、(33.65±3.51)%,CD4+(31.08±4.81)%、CD4+/CD8+(1.22±0.07)水平高于对照组(24.13±3.49)%、(1.13±0.10),差异有统计学意义(P<0.05)。结论子宫肌瘤患者接受腹腔镜下肌瘤剔除术治疗是安全可行的,利于加快卵巢功能恢复,对免疫功能抑制较轻。

Objective To observe the effect of laparoscopic myomectomy and transabdominal myomectomy on ovarian function and immune function in patients with uterine fibroid. Methods 80 patients with uterine fibroid treated in the hospital from July 2017 to June 2018 were selected, and they were divided into two groups by random number table, with 40 cases in each group. Control group was given transabdominal myomectomy, while observation group was treated with laparoscopic myomectomy. The ovarian function indexes [follicle stimulating hormone(FSH), luteinizing hormone(LH)], immune function indexes [CD4+, CD8+, CD4+/CD8+] in the two groups before and after surgery were observed. Results Before surgery, there was no statistical difference in the levels of FSH, LH, CD4+, CD8+, CD4+/CD8+ between the two groups(P>0.05);After surgery, the FSH, LH and CD8+ in observation group [(20.40±1.48)U/L,(19.15±1.24)U/L,(29.10±2.63)%] were higher than those in control group [(23.97±1.54)U/L,(22.57±1.38)U/L,(33.65±3.51)%], while the CD4+ and CD4+/CD8+ in observation group [(31.08±4.81)%,(1.22±0.07)] were higher than those in control group [(24.13±3.49)%,(1.13±0.10)](P<0.05). Conclusions Laparoscopic myomectomy in treatment of patients with uterine fibroid is safe and feasible, it can accelerate recovery of ovarian function and reduce suppression on immune function.